In this introduction to the 'Beyond commissioning' panel discussion recorded at the Annual Health Strategy Summit 2011, Dr Judith Smith, Head of Policy at the Nuffield Trust, reflects on the impact of commissioning in the NHS, with research evidence suggesting that commissioning has not made a significant strategic impact on secondary care.

Judith reflects on what might be needed to ensure GP commissioners can rise to the efficiency challenges in the next few years in the context of financial constraints, an inability to shift funding to prevention, and another reorganisation.

For further information, visit the Nuffield Trust website: nuffieldtrust.org.uk.

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